There have been big changes for hospitals in west London this year and more, just as controversial, are in the pipeline.

Amid a contentious time for the trust, Dr Tracey Batten came over from her native Australia to start as chief executive of the trust in February this year and was met with a raft of complicated changes through the Shaping a Healthier Future programme.

The closure, which came at the same time as nearby Central Middlesex’s A&E closure, was met with anger by the Save our Hospitals campaign made up of patients, residents and politicians.

Dr Batten said the trust is trying to centralise services as clinical evidence shows having everything in the same place will benefit patients.

She said: “By having emergency patients going straight to A&E at St Mary’s we know we have a better chance of survival and caring for them because it’s not just about having the initial emergency treatment. For example, if there’s been a bad car crash we can have specialist neurosurgeons as well as plastics and a cardiac surgeon all in the same place to give the best care to the patient as opposed to having a thin spread across all the hospitals.

“We’ve looked very carefully at travel times and clinically it’s beneficial to have specialist hospitals.”

One question Dr Batten still cannot answer is what the A&E will look like when it changes to a ‘local hospital’ emergency department.

She said: “To understand what the future scope of A&E services will be, we need some guidance from NHS England. We are trying to get a consistent definition for across England. I can understand why the community want us to tell them now but we need to be in sync with the rest of the country. The changes are a five year plan so it’s not going to be immediate.”

Talking about the reduction in beds at Charing Cross, Dr Batten, said they have had to look at the future of the area’s population and a change in mindset.

“Currently we look at illness but that needs to change to wellness which is quite a different mindset. We need to keep people well at home rather than coming to hospital. Patients coming into hospital would be easier for us but it’s better for people to not have to come into hospital in the first place.

"Lots of people, especially the elderly tell us they would rather have ongoing treatment at home so that’s what we’re trying to do. It’s just a different clinical outlook which we all need to wrap our heads around but will benefit everyone.”